• Reimbursement for Multiple Tests Performed During Same Encounter


    Updated March 20, 2017

    Question: If we perform a visual field, optic nerve OCT and pachymetry the same day, are we only reimbursed for one of the tests? Do payers reimburse only for the lowest allowable?

    Answer: Through Dec. 31, 2016, when billing multiple tests the same day that are not bundled , the Multiple Procedure Payment Reduction rule specifies payment of:

    • 100 percent allowable of the first test
    • 80 percent of the technical component on the second and subsequent tests (a 20 percent reduction).

    Note: While visual fields and optic nerve OCTs are not currently bundled together, payers do not expect to see these two tests performed the same day often.